by Jennie Harris, PhD, MPH


It only takes one dose.

Though I’ve worked in public health for a decade, I’ve never thought about rubella, a.k.a. German measles, until a recent project required me to. We’re privileged to not worry about rubella and congenital rubella syndrome (CRS) in the United States since we rarely encounter these diseases – thanks to vaccination. However, during the last big pre-vaccination epidemic in 1962-65, the United States had 12.5 million rubella cases, 20,000 babies born with CRS, and over 13,000 fetal/neonatal deaths.  Unfortunately rubella is still present in many countries; and as long as rubella virus continues to circulate, imported cases will remain a public health concern in the United States.

Rubella is a disease that is spread by droplets when an infected person sneezes or coughs. Luckily the disease is usually mild in children and adults; common symptoms are rash, low fever, and swollen lymph nodes behind the ears. People sometimes don’t even realize that they have it. But if a woman is infected during her first trimester of pregnancy, there is up to a 90% chance that she will pass the virus to her fetus. This can cause miscarriage, stillbirth, or CRS. CRS causes many different birth defects including hearing and vision loss, heart defects, and developmental delays.

We’ve been vaccinating people in the United States against rubella since 1969. We use measles, mumps and rubella vaccine, called MMR.  But the rubella vaccine component is considered too expensive in some countries and some people don’t consider rubella to be as dangerous as other vaccine-preventable diseases.  Also, some children are not vaccinated because of the barriers to reaching every child for vaccination. Currently, only 4 out of 10 children worldwide receive rubella vaccine.

Unvaccinated girls eventually grow up and are susceptible to rubella while pregnant (unless they were previously infected with rubella virus). On a global scale, rubella virus infection during pregnancy results in more than 100,000 babies born with CRS each year. That’s a LOT of babies with serious birth defects; most of whom live in countries with limited support services for persons with disabilities. Rubella virus infection during pregnancy can also cause miscarriages and stillbirths.

All from a disease that is preventable with just one shot.

Just one shot.  One shot and a child will be able to hear music, see rainbows, play actively and grow up healthy.Jennie CDC

Fortunately, the global health community is working hard to increase access to rubella vaccine. The number of countries where rubella vaccine is routinely offered to children increased from 79 to 137 (70% of all countries) from 1996 to 2013 with several more countries planning introduction in 2014-2015.  And people are working tirelessly throughout the world, including in the United States, to decrease barriers to vaccination so all children are protected from vaccine-preventable diseases.

I look forward to the day when the rest of the world has the privilege to not worry about rubella.


[Editor’s note: There’s an awesome infographic available, if anyone would care to use it!]